Healthcare Provider Details

I. General information

NPI: 1548335821
Provider Name (Legal Business Name): ROGER JOSEPH GELINAS JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7627 W 88TH AVE
WESTMINSTER CO
80005-1684
US

IV. Provider business mailing address

1235 MILL CREEK RD
BERTHOUD CO
80513-8083
US

V. Phone/Fax

Practice location:
  • Phone: 303-432-8884
  • Fax:
Mailing address:
  • Phone: 303-845-2973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR-5992
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: